Provider Demographics
NPI:1841282506
Name:FRENCH, KATHLEEN BRELSFORD (MD)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:BRELSFORD
Last Name:FRENCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 HAMAKER CT
Mailing Address - Street 2:SUITE B 104
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2238
Mailing Address - Country:US
Mailing Address - Phone:703-641-4877
Mailing Address - Fax:703-641-1123
Practice Address - Street 1:3020 HAMAKER CT
Practice Address - Street 2:SUITE B 104
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2238
Practice Address - Country:US
Practice Address - Phone:703-641-4877
Practice Address - Fax:703-641-1123
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042074207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
07147OtherBLUE CHOICE
30888OtherOPT CHOICE
VA615298Medicaid
0488417OtherAETNA
0600023OtherUNITED HEALTHCARE
30888OtherMDIPA
30888OtherMAMSI
NJ0029467OtherMEDICAID
1383241OtherFIRST HEALTH
077829OtherANTHEM
30888OtherALLIANCE
7147OtherNAS
077829OtherHEALTH KEEPERS
7147OtherCAREFIRST
30888OtherMDIPA
077829OtherANTHEM